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Abstract

Introduction: Few studies of acculturation examined the interaction between community-level factors (neighborhood median income, ethnic composition, etc.) and individual-level acculturation measures, while an individual’s acculturation status might function through community-level factors to have an impact on his/her health.

Methods: We pool the 2005 and 2007 Los Angeles County Health Survey data to construct a multilevel dataset, using zip-code-level median household income and immigrant density (drawn from the United States Census) to aggregate ZIP-codes into larger areas to ensure sufficient sample size in each geographic unit for multilevel analysis. We interact the neighborhood median household income (NMHI) and immigrant density variables with each individual’s linguistic acculturation (i.e., speaking English at home) to examine the interaction’s association with physical inactivity, obesity and hypertension. We include perceived public safety as a covariate to test the hypothesis that perceived public safety mediates the association between acculturation and health outcomes.

Results: Linguistic acculturation is a modifier of the relationship between NMHI and physical inactivity, as well as the association between NMHI and obesity outcome. The interaction between higher NMHI and higher linguistic acculturation is negatively associated with physical inactivity and obesity at the individual level (for physical inactivity: OR=.624, 95% CI=.473 - .823; for obesity: OR=.517, 95% CI=.384 - .696). These odds ratios remain significant after we include the individual’s perceived public safety.

Discussion: This study shows a possible pathway between acculturation and health outcomes (though no causal conclusions can be drawn): higher-level linguistic acculturation interacts with higher community-level income to generate lower level of physical inactivity and obesity.